摘要
目的研究颅脑损伤手术患者术后感染的相关因素,为颅脑损伤手术术后颅内感染的防治提供理论依据。方法本研究纳入对象为2015年1月—2018年1月于上海交通大学医学院附属新华医院行颅脑损伤手术的425例颅脑损伤患者,参照颅内感染诊断标准判断住院期间颅内感染情况。将发生颅内感染的患者设为观察组,未发生颅内感染的患者设为对照组,记录两组患者年龄、性别、手术及住院时间等病历资料,采用单因素分析及Lojistic回归分析探究颅脑损伤手术患者术后感染的独立危险因素。结果 425例颅脑损伤手术患者术后发生颅内感染30例,感染率70.58%,手术结束至颅内感染最短1d,最长7d,平均(3.56±0.54)d,死亡3例,死亡率10.00%;两组合并基础疾病、术后白蛋白(albumin,ALB)、住院时间、术后斯哥昏迷(Glasgow Coma Scale,GCS)评分、急诊手术、留置引流管时间、术后脑脊液漏、手术时间、手术部位差异有统计学意义(P<0.05),年龄、性别、术中开放脑室放置颅内压监测仪(ICP)探头差异无统计学意义(P>0.05);独立危险因素为手术时间≥3h(OR=2.865,95%CI为1.153,7.543)、急诊手术(OR=3.215,95%CI为1.103,9.653)、留置引流管≥2d(OR=3.431,95%CI为0.875,7.397)、术后脑脊液漏(OR=3.154,95%CI为0.875,6.356)、幕下手术(OR=2.657,95%CI为1.222,8.346)。结论手术时间≥3h、急诊手术、留置引流管≥2d、术后脑脊液漏、幕下手术均会增加颅脑损伤手术患者术后颅内感染风险。
Objective To investigate the related factors of postoperative infection in patients with craniocerebral injury,provide a theoretical basis for the prevention and treatment of postoperative infection in patients with craniocerebral injury.Methods 425 patients with craniocerebral injury underwent surgery in hospital from January 2015 to January 2018 were selected and divided into observation group(with intracranial infection)and control group(without intracranial infection).The age,gender,operation time and hospitalization time were recorded.The univariate analysis and the lojistic regression analysis were used to explore the independent risk factors of postoperative infection in patients with craniocerebral injury.Results The intracranial infection rate was 70.58%(30/425);The shortest intracranial infection was 1 d after operation and the longest was 7 d after operation,the average was(3.56±0.54)d;The death rate was 10.00%(3 cases);The underlying diseases,prevalences of albumin(ALB),hospital stay,postoperative Glasgow Coma Scale(GCS)score,emergency surgery,indwelling drainage tube time,postoperative cerebrospinal fluid leakage,operative time,surgical site of the two groups showed significant difference(P<0.05),while no difference was found in the age,gender,intracranial pressure(ICP)probe placement(P>0.05).The independent risk factors were surgery time≥3 h(OR=2.865,95%CI:1.153,7.543),emergency operation(OR=3.215,95%CI:1.103,9.653),indwelling drainage tube≥2 d(OR=3.431,95%CI:0.875,7.397),postoperative CSF leakage(OR=3.154,95%CI:0.875,6.356),and infratentorial surgery(OR=2.657,95%CI:1.222,8.346).Conclusion Surgery time≥3 h,emergency surgery,indwelling drainage tube≥2 d,postoperative cerebrospinal fluid leakage,infratentorial surgery will increase the risk of intracranial infection after craniocerebral injury surgery.
作者
傅仕菁
FU Shi-jing(Operating Room,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《实用心脑肺血管病杂志》
2018年第A02期21-23,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
颅脑损伤
术后感染
相关因素
Craniocerebral injury
Postoperative infection
Related factors
